Back and Neck Pain
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Common Types of Back and Neck Pain
Back and neck pain can occur in many forms. Some types of pain are more serious than others, so it is important to seek evaluation and care from an expert.
Lumbar (back) or cervical (neck) strain can occur after any event that stresses the tissues and can range in severity. This soft-tissue injury can occur due to trauma, improper use, or overuse. Injuries often heal within days or weeks and are referred to as acute. Those injuries lasting longer than three months are considered chronic.
The most common types of back and neck pain are detailed below.
Herniated discs are often referred to as slipped or ruptured discs. The condition results from a tear in the outer layer of a disc (the rubber-like section between the spaces in the spine). It can happen in any part of the spine but is most common in the lumbar (lower back) or cervical (neck) regions of the spine. Herniated discs can happen to people of ages, including children, and affect both men and women.
Herniated Disc Symptoms
The symptoms of a slipped disc vary from person to person, depending on the size and location of the herniation, weight, fitness level, and other factors. The most common symptoms include:
- Intermittent or continuous back pain (this may be made worse by movement, coughing, sneezing, or standing for long periods of time)
- Spasm of the back muscles
- Pain that starts near the back or buttock and radiates down the leg to the calf or into the foot (this is from “sciatica,” meaning pressure on the large sciatic nerve in the lower back, buttocks, and legs)
- Muscle weakness in the legs
- Numbness in the leg or foot
- Decreased reflexes at the knee or ankle
Treatment Options for Herniated Disc
Once a diagnosis is confirmed, an individual with a herniated disc should be referred to a major spine center for a full evaluation and individualized treatment plan.
Treatments for ruptured discs vary, depending on the location and severity of damage. Treatment options are usually conservative at first, and can include:
- Bed rest
- Over-the-counter pain medications
- Muscle relaxants
- Occupational therapy
- Injection therapy
In most cases, the symptoms will resolve within four to six weeks.
If these initial treatments are ineffective, other options will be considered. The spine team at the Weill Cornell Medicine Center for Comprehensive Spine Care believes in an interdisciplinary approach to the treatment of ruptured discs, including physiatry, pain management, and physical therapy. Minimally invasive surgery is considered only when necessary.
Spondylolisthesis refers to the forward or backward displacement of a bone in the vertebral column, leading to misalignment of the vertebrae in the spine. It is not the same as a herniated disc, although the two can coexist.
Isthmic spondylolisthesis is the most common form, which occurs with a slip or fracture of the intervertebral discs. When spondylolisthesis occurs in children or teens, it is usually due to a birth defect or a traumatic injury. (In fact, spondylolisthesis is the most common cause of back pain in teens.) In adults, the most common cause of spondylolisthesis is natural wear and tear due to aging and arthritis.
Symptoms of Spondylolisthesis
Symptoms of spondylolisthesis range in severity, depending on the location and cause of the slippage. Some people may have no pain at all or have only mild back pain. However, as the condition worsens, symptoms may include:
- Low-back pain, ranging from mild to severe
- Changes in posture and gait
- Hamstring muscle tightness or spasms
- Buttock pain, numbness, or tingling
- Back stiffness
- Weakness or tingling in the legs and feet
- Tenderness around the area of the slipped disc
Non-surgical treatment options for spondylolisthesis include:
- Physical therapy
- Thermal treatment
- Lumbar traction
- Electrical stimulation
- Medications, such as nonsteroidal anti-inflammatory medicines, combined with acetaminophen, or corticosteroids
- Epidural steroid injections
- Lumbosacral orthotic device
Finally, when surgery is not an option, neuromodulation can be a worthwhile option.
Spinal Stenosis is a condition in which open spaces within the spine become narrowed, causing pressure on the spinal cord and nerves of the spine. It can be a natural result of aging, as the spinal canal becomes compressed through years of wear and tear. In other cases, spinal stenosis can be attributed to a specific cause such as an injury, accident, or a related spine condition such as a herniated disc.
Spinal Stenosis Symptoms
When pressure is placed on the spinal cord, it may result in swelling of the cord. Symptoms may come on either suddenly or gradually and may include:
- Difficulty walking
- Balance problems
- Dropping items
- Difficulty with fine motor skills, such as buttoning, handwriting, or picking up small objects
- Arm or leg weakness, cramping
- Changes in bladder or bowel function
Treatment Options for Spinal Stenosis
The first course of treatment includes exercises to improve flexibility, as well as anti-inflammatory and neuropathic medications to help relieve pain.
Other treatments include:
- Epidural injections
- Spinal cord stimulation
- Intrathecal delivery of medication
Neck pain is not uncommon and may result from a variety of disorders, injuries, and diseases of any of the tissues in the neck. Increased risk factors for injury include contact sports, horseback riding, weightlifting, and motor vehicle collisions. Neglecting good posture can put a strain on inappropriate muscles, causing quite severe symptoms, which often recur over time.
Neck Pain Symptoms
- Pain between the shoulder blades that can be dull or sharp
- Pain that radiates down the arms to the hands
- Muscle spasms
- Numbness, tingling, or weakness in the arms, hands, or fingers
- Muscle atrophy
Treatment Options for Neck Pain
There are multiple non-surgical measures that you can take to obtain relief of pain. Application of heat or cold, traction, physical therapy including ultrasound, massage, and manipulation may all improve your symptoms, and help strengthen the muscles in the neck.
Other treatments include:
- Local injections of corticosteroids
- Analgesics, including nonsteroidal anti-inflammatory drugs or topical anesthetic creams
- Other anti-inflammatory medications or injections
Why Choose Weill Cornell Medicine for Back and Neck Pain?
The Center for Comprehensive Spine Care in New York City consists of specialists in neurology, pain management, neurosurgery, psychiatry, radiology, and psychology. The multidisciplinary team provides personalized and precise care and treatment options for all types of back and neck pain.
The physicians at Weill Cornell Medicine Division of Pain Management use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop a customized pain management plan for each patient. We work closely with a broad team of specialists to provide the highest quality care, often in our spa-like, office-based setting.
Finally, we offer the latest options in medication therapy, including low-dose naltrexone, medical marijuana, and a complement of topical treatments.
Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.
Contact us today to schedule a consultation.